NPI | 1275571960 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2225) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2003023862) |
Enumeration Date | 2006-06-03 |
Last Update Date | 2025-08-18 |